Basic Information
| Provider Information | |||||||||
| NPI: | 1073628871 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GERMAN | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 222 S WOODS MILL RD | ||||||||
| Address2: | SUITE 750 | ||||||||
| City: | CHESTERFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630173625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3142056600 | ||||||||
| FaxNumber: | 3144345939 | ||||||||
| Practice Location | |||||||||
| Address1: | 222 S WOODS MILL RD | ||||||||
| Address2: | SUITE 750 | ||||||||
| City: | CHESTERFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630173625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3142056600 | ||||||||
| FaxNumber: | 3144345939 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2006 | ||||||||
| LastUpdateDate: | 08/06/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | R6P06 | MO | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
ID Information
| ID | Type | State | Issuer | Description | P00294903 | 01 | RR MEDICARE | OTHER | 841682728 | 01 | TAX ID | OTHER | 203166715 | 05 | MO | MEDICAID |